Grand Home Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

GRAND HOME DIALYSIS LLC

Doing business as

Grand Home Dialysis

Practice address

14671 W Mountain View Blvd
Ste 106
Surprise, AZ 85374-4840

Phone

(623) 546-6120

Fax

(623) 546-2693

NPI assigned

Oct 25, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel T Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grand Home Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

DaVita Grand Home DialysisCCN 032620

Ownership

Profit

Certified

Jun 18, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

4

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  dba Parkland Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Parkland, WA
  • NPI 1881987485

  Member Of

  NPD member

Locations

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Liqun Bai, MD

  • Nephrology Physician
  • Sun City, AZ
  • NPI 1609827286

  Dialysis facility

  Care Compare affiliation Name & address match
• Nandini Paul Sharma, M.D.

  • Nephrology Physician
  • Surprise, AZ
  • NPI 1861432007

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1780863878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14671 W MOUNTAIN VIEW BLVD",
            "address_2": "STE 106",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744840",
            "telephone_number": "623-546-6120",
            "fax_number": "623-546-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND HOME DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "633472",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grand Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Ann Graham, P.T.
• Marissa Grahlman, EDS., NCSP
• Mackenzzie Grahn
• Ceslii Granado, OTR
• Francisco Granados Monge, PTA
• Jeffrey Morton Grant, MD
• Jasmine Graves
• Kaitlyn Gray, PTA
• Kyla Camille Gray, MSN, FNP-C, PMHNP-C
• Byron Kent Grayson, P.A

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Surprise, AZ
• Providers in Surprise, AZ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.